Senior Claims Specialist - Workers Compensation

Summit Consulting; New Jersey; On-site; USD 105,000 - 125,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

401(k) match

Employee stock purchase plan

Commuter benefits

Paid time off and holidays

Tuition reimbursement

Job summary

Great American Insurance Group, through Strategic Comp in New Jersey, seeks a Senior Claims Specialist to manage New Jersey workers' compensation claims remotely, working Eastern Time Zone hours. You will investigate claims, establish reserves, and negotiate settlements to drive timely resolutions.

The ideal candidate has 10+ years of NJ WC adjusting experience, strong knowledge of NJ laws, and excellent communication.

Qualifications

• 10+ years of New Jersey workers' compensation claims adjusting experience, including complex or high-exposure claims.
• Strong knowledge of New Jersey workers' compensation laws, regulations, and claims practices.
• AIC designation is preferred.
• Ability to work Eastern Time Zone business hours and travel occasionally as needed.
• Excellent written and verbal communication with diverse stakeholders.

Responsibilities

• Manage New Jersey workers' compensation claims from inception through resolution.
• Analyze claim facts and evaluate coverage, compensability, and benefits eligibility.
• Develop and execute strategies to achieve timely and favorable claim outcomes.
• Establish and maintain appropriate claim reserves.
• Negotiate settlements and bring about claim resolution.
• Communicate regularly with claimants, insureds, employers, and other stakeholders.
• Prepare and present large loss reports to internal and external audiences.
• Collaborate with defense counsel on litigation strategy and claim resolution.
• Partner with medical case managers, surveillance vendors, and other external resources.
• Ensure compliance with New Jersey workers' compensation laws and regulations.
• Maintain accurate and timely claim documentation.
• Analyze claim trends and exposure to support effective decision-making.

Skills

Communication

NJ WC knowledge

Claim adjusting

Negotiation

Education

AIC designation

Job description

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a \"small company\" culture where your ideas will be heard with \"big company\" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. This position is not eligible for employment visa sponsorship. Applicants must be authorized to work in the United States without the need for current or future sponsorship.

Who We Are

Strategic Comp is a leading provider of workers' compensation insurance for large employers committed to protecting their workforce. As part of Great American Insurance Group, we combine the strength and stability of a trusted organization with more than 150 years of history with the entrepreneurial spirit of a growing business. Through our specialized insurance expertise and field-based service model, we build lasting partnerships and deliver exceptional results for our customers. Our culture is built on collaboration, excellence, and a shared commitment to serving our customers and one another. We combine a \"small company\" culture where your ideas will be heard with \"big company\" expertise to help you succeed.

Position Summary

Strategic Comp is seeking an experienced Senior Claims Specialist to manage New Jersey workers' compensation claims. This role is responsible for investigating claims, determining compensability, establishing reserves, negotiating settlements, and developing strategies that drive effective claim resolution. We take an extremely aggressive and proactive approach to claims adjusting and are looking for the person who not only knows their jurisdiction’s comp laws, but also enjoys the role of putting that experience to good use. Because we focus on outcomes and not just processes, we look for the adjuster who is very skilled at developing strategies to bring claims to resolution. This is a remote position that requires working Eastern Time Zone business hours.

Responsibilities

• Manage New Jersey workers' compensation claims from inception through resolution.
• Analyze claim facts and evaluate coverage, compensability, and benefits eligibility.
• Develop and execute strategies to achieve timely and favorable claim outcomes.
• Establish and maintain appropriate claim reserves.
• Negotiate settlements and bring about claim resolution.
• Communicate regularly with claimants, insureds, employers, and other stakeholders.
• Prepare and present large loss reports to internal and external audiences.
• Collaborate with defense counsel on litigation strategy and claim resolution.
• Partner with medical case managers, surveillance vendors, and other external resources.
• Ensure compliance with Illinois workers' compensation laws and regulations.
• Maintain accurate and timely claim documentation.
• Analyze claim trends and exposure to support effective decision-making.
• Provide exceptional service while building strong relationships with customers and business partners.

Qualifications

• 10+ years of New Jersey workers' compensation claims adjusting experience, including complex or high-exposure claims.
• Strong knowledge of New Jersey workers' compensation laws, regulations, and claims practices.
• Professional industry designations such as Associate in Claims (AIC) are preferred.
• Ability to work Eastern Time Zone business hours and travel occasionally as needed.
• You must be a great communicator, in both written and verbal form, and be able to work with a variety of internal and external contacts.

Business Unit: Strategic Comp

Salary Range: $105,000.00 -$125,000.00

Benefits: We offer competitive benefits packages for full-time and part-time employees*. Full-time employees have access to medical, dental, and vision coverage, wellness plans, parental leave, adoption assistance, and tuition reimbursement. Full-time and eligible part-time employees also enjoy Paid Time Off and paid holidays, a 401(k) plan with company match, an employee stock purchase plan, and commuter benefits. Compensation varies by role, level, and location and is influenced by skills, experience, and business needs. Learn more at http://www.gaig.com/careers. *Excludes seasonal employees and interns.

Why can you trust Great American Insurance Group?

Great American Insurance Group understands the importance of choosing a financially strong company. We are an organization built for the long term and are committed to giving you that strength. For nearly 150 years, Americans have trusted us to protect them. Our innovative insurance solutions and specialization serves niche marketplaces that we know well. This expertise gives us a successful foundation that spans generations. You never know where a career in insurance will take you. Whether you are starting your career or are looking for a company to grow your experience, at Great American Insurance Group, you can join our more than 8,500 employees to “Be Here. Be GREAT!”